PMID- 26840595 OWN - NLM STAT- MEDLINE DCOM- 20171107 LR - 20171121 IS - 1540-8167 (Electronic) IS - 1045-3873 (Linking) VI - 27 IP - 5 DP - 2016 May TI - Diffuse Ventricular Fibrosis on Cardiac Magnetic Resonance Imaging Associates With Ventricular Tachycardia in Patients With Hypertrophic Cardiomyopathy. PG - 571-80 LID - 10.1111/jce.12948 [doi] AB - INTRODUCTION: Non-sustained ventricular tachycardia (NSVT) is a risk factor for sudden cardiac death (SCD) in patients with hypertrophic cardiomyopathy (HCM). We aimed to assess whether diffuse ventricular fibrosis on cardiac magnetic resonance (CMR) imaging could be a surrogate marker for ventricular arrhythmias in patients with HCM. METHODS: A total of 100 patients with HCM (mean age 51 +/- 13 years, septal wall thickness 20 +/- 5 mm) underwent CMR with a 1.5 T scanner to determine the presence of ventricular late gadolinium enhancement (LGE) for focal fibrosis, and post-contrast T1 mapping for diffuse ventricular fibrosis. The presence of NSVT was determined by Holter monitoring and a subset of high risk patients received an implantable cardioverter-defibrillator (ICD). RESULTS: NSVT was detected in 23 of 100 patients with HCM. Focal ventricular fibrosis (by LGE) was observed in 87%, with no significant difference between patients with (96%) or without NSVT (86%, P = 0.19). However, LGE mass was greater in patients with (16.5 +/- 19.1 g) versus without NSVT (7.6 +/- 10.2 g, P < 0.01). NSVT was associated with a significant reduction in ventricular T1 relaxation time (422 +/- 54 milliseconds) versus patients without NSVT (512 +/- 115 milliseconds; P < 0.001). There was significant reduction in ventricular T1 relaxation time in patients with (430 +/- 48 milliseconds) versus without aborted SCD (495 +/- 113 milliseconds; P = 0.01) over a mean follow-up of 40 +/- 10 months. On multivariate analysis post-contrast ventricular T1 relaxation time and septal wall thickness were the only predictors of NSVT. CONCLUSION: Post-contrast T1 relaxation time on CMR is associated with ventricular arrhythmias in patients with HCM. Diffuse ventricular fibrosis may be an important marker of arrhythmic risk in patients with HCM. CI - (c) 2016 Wiley Periodicals, Inc. FAU - McLELLAN, Alex J A AU - McLELLAN AJ AD - Department of Cardiovascular Medicine, Alfred Hospital and Baker IDI Heart and Diabetes Institute, Melbourne, Victoria, Australia. AD - Cardiology Department, Royal Melbourne Hospital, Melbourne, Victoria, Australia. AD - Faculty of Medicine, Dentistry, and Health Sciences, University of Melbourne, Melbourne, Victoria, Australia. FAU - Ellims, Andris H AU - Ellims AH AD - Department of Cardiovascular Medicine, Alfred Hospital and Baker IDI Heart and Diabetes Institute, Melbourne, Victoria, Australia. FAU - Prabhu, Sandeep AU - Prabhu S AD - Department of Cardiovascular Medicine, Alfred Hospital and Baker IDI Heart and Diabetes Institute, Melbourne, Victoria, Australia. AD - Cardiology Department, Royal Melbourne Hospital, Melbourne, Victoria, Australia. AD - Faculty of Medicine, Dentistry, and Health Sciences, University of Melbourne, Melbourne, Victoria, Australia. FAU - Voskoboinik, Alex AU - Voskoboinik A AD - Department of Cardiovascular Medicine, Alfred Hospital and Baker IDI Heart and Diabetes Institute, Melbourne, Victoria, Australia. FAU - Iles, Leah M AU - Iles LM AD - Department of Cardiovascular Medicine, Alfred Hospital and Baker IDI Heart and Diabetes Institute, Melbourne, Victoria, Australia. FAU - Hare, James L AU - Hare JL AD - Department of Cardiovascular Medicine, Alfred Hospital and Baker IDI Heart and Diabetes Institute, Melbourne, Victoria, Australia. FAU - Kaye, David M AU - Kaye DM AD - Department of Cardiovascular Medicine, Alfred Hospital and Baker IDI Heart and Diabetes Institute, Melbourne, Victoria, Australia. FAU - Macciocca, Ivan AU - Macciocca I AD - Victorian Clinical Genetics Services, Murdoch Childrens Research Institute, Melbourne, Victoria, Australia. FAU - Mariani, Justin A AU - Mariani JA AD - Department of Cardiovascular Medicine, Alfred Hospital and Baker IDI Heart and Diabetes Institute, Melbourne, Victoria, Australia. FAU - Kalman, Jonathan M AU - Kalman JM AD - Cardiology Department, Royal Melbourne Hospital, Melbourne, Victoria, Australia. AD - Faculty of Medicine, Dentistry, and Health Sciences, University of Melbourne, Melbourne, Victoria, Australia. FAU - Taylor, Andrew J AU - Taylor AJ AD - Department of Cardiovascular Medicine, Alfred Hospital and Baker IDI Heart and Diabetes Institute, Melbourne, Victoria, Australia. FAU - Kistler, Peter M AU - Kistler PM AD - Department of Cardiovascular Medicine, Alfred Hospital and Baker IDI Heart and Diabetes Institute, Melbourne, Victoria, Australia. AD - Cardiology Department, Royal Melbourne Hospital, Melbourne, Victoria, Australia. AD - Faculty of Medicine, Dentistry, and Health Sciences, University of Melbourne, Melbourne, Victoria, Australia. LA - eng PT - Journal Article PT - Observational Study PT - Research Support, Non-U.S. Gov't DEP - 20160314 PL - United States TA - J Cardiovasc Electrophysiol JT - Journal of cardiovascular electrophysiology JID - 9010756 RN - 0 (Contrast Media) RN - K2I13DR72L (Gadolinium DTPA) SB - IM MH - Adult MH - Aged MH - Cardiomyopathy, Hypertrophic/complications/*diagnostic imaging/pathology/physiopathology MH - Chi-Square Distribution MH - Contrast Media/administration & dosage MH - Death, Sudden, Cardiac/etiology/prevention & control MH - Defibrillators, Implantable MH - Electric Countershock/instrumentation MH - Electrocardiography, Ambulatory MH - Female MH - Fibrosis MH - Gadolinium DTPA/administration & dosage MH - Humans MH - Logistic Models MH - *Magnetic Resonance Imaging MH - Male MH - Middle Aged MH - Multivariate Analysis MH - Myocardium/*pathology MH - Predictive Value of Tests MH - Prospective Studies MH - Risk Factors MH - Tachycardia, Ventricular/diagnosis/*etiology/physiopathology/therapy OTO - NOTNLM OT - MRI OT - cardiac magnetic resonance OT - hypertrophic cardiomyopathy OT - implantable cardioverter defibrillator OT - myocardial fibrosis OT - ventricular tachycardia EDAT- 2016/02/04 06:00 MHDA- 2017/11/08 06:00 CRDT- 2016/02/04 06:00 PHST- 2015/11/11 00:00 [received] PHST- 2015/12/28 00:00 [revised] PHST- 2016/01/12 00:00 [accepted] PHST- 2016/02/04 06:00 [entrez] PHST- 2016/02/04 06:00 [pubmed] PHST- 2017/11/08 06:00 [medline] AID - 10.1111/jce.12948 [doi] PST - ppublish SO - J Cardiovasc Electrophysiol. 2016 May;27(5):571-80. doi: 10.1111/jce.12948. Epub 2016 Mar 14.